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Decreasing daily blood work in hospitals: What works and what doesn't
Author(s) -
Jalbert Rochelle,
Gob Alan,
ChinYee Ian
Publication year - 2019
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.13015
Subject(s) - context (archaeology) , intervention (counseling) , audit , quality (philosophy) , variety (cybernetics) , process management , health care , quality management , root cause analysis , work (physics) , medicine , process (computing) , operations management , narrative , medical education , computer science , nursing , business , engineering , management system , political science , philosophy , artificial intelligence , law , linguistics , forensic engineering , biology , paleontology , accounting , epistemology , mechanical engineering , operating system
Recurrent, inappropriate laboratory testing is a costly and wasteful use of healthcare resources. Recognizing this problem, the American Board of Internal Medicine, Canadian Society of Internal Medicine, and the Canadian Association of Pathologist all supported the Choosing Wisely campaign to reduce laboratory investigations in patients who demonstrate clinical and laboratory stability. In this narrative, we review studies looking at a variety of approaches to reduce excessive testing including education, audit and feedback, computerized physician order entry system changes, and forcing functions. Each type of intervention has its own unique advantages and disadvantages, varying in complexity, disruptiveness, effectiveness, and sustainability. Before implementing any quality improvement project, it is important to analyze the local context to identify the root causes for the practice behavior and aim to use the minimal amount of intervention to achieve the desired result. Change is often incremental and will seldom occur with a single intervention or Plan‐Do‐Study‐Act cycle. Garnering the support of opinion leaders and a quality improvement team will help make the process and intervention a success.